| What
about the Dad?  Doulas
definitely support the partners too! During the prenatal visits,
the role the partner wishes to take throughout the labour and birth
is discussed. It’s important also for him to feel he can change
his mind when the time comes around too! My role is to respect his
wishes and support him through this process as well. This is a journey
for birth of you.
Some partners like to take a very active role in labour, confidently
supporting their woman through every contraction with unflagging
energy, encouragement and good humour. Others calmly provide massage,
cool cloths and endless hours of walking and slow dancing.
Still others like to be a quiet presence, happy to be nearby but
feeling somewhat overwhelmed in the ‘woman’s world’
of birthing, anxious in the medical environment, and unsure of what
support is needed or wanted. Some aren’t sure how they feel
and the doula can provide reassurance, encouragement, and practical
advice and also facilitate communication between them, the woman,
and medical staff.
Sometimes the role the partner
and I take change throughout the woman’s labour. I model emotional
and physical support techniques, and give them the encouragement
and space to develop their own style of labour support. I then take
care of practical tasks so the partner can focus on the birthing
woman. Birth can be an immensely exciting time for partners, and
one that can be extremely validating and confidence building as
they make the transition to fatherhood. But it can also be an overwhelming
and anxious time for them.
 Supporting
a woman to labour and birth normally can be hard physical and emotional
work. For a partner working by himself supporting his woman is a
marathon task, as he does not have the wonderful endorphins provided
to the woman by her body, relieving her pain and rendering her unaware
of the passage of time. Having a doula present enables the partner
or husband to participate in the birth at his comfort level.
As a doula, I can also prepare food for you both as necessary, and
also provide reminders to you both to eat and drink. When your partner
needs a break to attend to his own needs, he can be assured that
you will be supported through every contraction by your doula.
No one can replace a woman’s
partner or husband at the birth because of the incredible connection
that exists between you. It is an honour to be witness to this and
it fuels everyone throughout the labour. The emotional support and
comfort that your husband/ partner can bring to you during labour
are of a quality no other can provide. As a doula, I understand
that this support is essential to you in labour and by doing the
physical work of heating up the hot packs, filling the bath, applying
counter pressure to your lower back or taking photos, enables your
husband/partner to focus their full energy on providing you with
this wonderful form of support and attention.
Seeing couples travel the labour journey to birth is both stunning
and inspiring. Neither has been there before but they use their
bond, their strength and their love to achieve whatever experience
is important to them.
Where does the word ‘doula’
come from?
The
word ‘doula’ comes from ancient Greek, meaning ‘woman’s
servant’. Another translation is ‘to mother the mother’.
Throughout history and in much of the world today, a cadre of women
support a woman through labour and birth, giving back rubs and providing
continuous emotional support. Like their historical counterparts,
doulas know how to help a woman in labour feel better. However,
today’s doulas are much more diverse than their predecessors.
Who has a doula?
Some couples have a doula with their first birth, and others with
subsequent births. Some women who have been dissatisfied with a
previous birth experience and wish to achieve a better outcome hire
a doula for subsequent births. Women without the desired support
people available also hire doulas. Doulas attend births at hospitals,
birth centres and homebirths.
 Does
a doula replace medical staff (e.g midwife)?
No. Doulas do not replace midwives or other medical staff. Doulas
do not perform clinical or medical tasks such as taking blood pressure
or temperature, monitoring fetal heart rate, doing vaginal examinations
or providing postnatal care clinical care. They are there to comfort
and support the mother and to enhance communication between the
mother and medical staff.
What are the limitations
of the doula service?
Doulas are not midwives, nurses or doctors, and as such they do
not give medical advice or perform clinical tasks during labour
such as monitoring baby’s heart rate, performing vaginal exams,
assessing baby’s position, taking blood pressure etc. Doulas
do not make decisions or speak on behalf of the couple, yet they
can help the couple make informed decisions by ensuring all information
is obtained from the medical staff and understood. The doula agreement
outlines the role and limitations of the doula.
When in my pregnancy should
I book a doula?
The earlier the better. Although the number of visits you have
with your doula will be the same whether you contact her at 12 weeks
or at 35 weeks, the difference is that you'll have someone you know
that you can call on with those "Is this normal?" or "What
does this mean?" sort of phone calls throughout your pregnancy.
Also, the longer you have known your doula the more of a relationship
you will build and booking in advance assures her support for you.
What is the difference
between a midwife and a doula?
 A
midwife is trained to do medical procedures and evaluate the well
being of both mother and child, whereas your doula’s priority
is your emotional support and physical comfort.
As shifts change within the labour ward, you may see many different
midwives throughout your labour, whereas your doula stays with you
continuously. Your doula focuses only on you, but a midwife has
other mums and babies to look after and some can only check in on
you every half hour or hour for a matter of minutes.
Do I need a doula if I have
a midwife?
Most couples will answer ‘yes’ to this question. Although
there is some crossover between the roles of doulas and midwives,
there are many important distinctions. Primarily, the midwife's
responsibility peaks at the time of the birth, which is when she
must be at her most alert to perform her job effectively. This means
that she must conserve her energy throughout your labour to perform
her job as best as she can. This does not mean that midwives do
not provide labour support - they do- just that they have many other
responsibilities that must take precedence.
 In
contrast, a doula's responsibility peaks during active labour and
transition, when you need the most help coping with your contractions.
By the time the birth rolls around, the doula has already accomplished
most of her work--she has helped you through your labour to the
point of birth. As a result, a doula can afford to spend most of
her energy in the labour stage.
As the midwives are busy setting
up for the birth, taking fetal heart tones, charting, and many other
important tasks related to monitoring the health of mother and baby,
your doula is there with you, coaching you through each contraction,
heating up your hot packs, adding fresh water to your bath, and
fetching a glass of juice for you, and a coup of coffee for your
partner. Doulas are also very helpful at homebirths, where an extra
pair of hands to help with the clean-up, or whip up a post-baby
meal can come in very handy. Ideally, doulas and midwives work hand-in-hand
at every birth.
What effect does the presence
of a doula have on the mother?
 When
a doula is present during and after childbirth, women report greater
satisfaction with their birth experience, make more positive assessments
of their babies, reduced chance of maternal fever and infection,
have fewer caesareans and requests for medical intervention, and
less postnatal depression. Mothers also feel more secure, more in
control, have reduced levels of anxiety, reduced maternal bleeding
following birth and have a higher regard and increased sensitivity
towards their babies.
What effect does the presence of a doula
have on the baby?
Babies have shorter hospital stays and fewer admissions to special
care nurseries. Mothers are more affectionate to their babies in
postnatal period and there is an increased chance of successful
breastfeeding.
Does a doula make decisions
on our behalf?
A doula does not make decisions for clients or intervene in their
clinical care. She provides informational and emotional support,
while respecting a woman’s decisions.
What research is there
on doulas/birth support?
A review by Cochrane (a prestigious international organization
that prepares and keeps up-to-date systematic reviews in many areas
of health and medicine) on the effect of "Continuous Support
for Women During Childbirth*" has drawn astonishing conclusions.
The primary objective of this review was to assess the effects,
on mothers and their babies, of continuous, one-to-one intrapartum
support as compared to usual care.
Fifteen trials involving 12,791 women were included. After review
and analysis of the data, the researchers offered the following
synopsis: Continuous labour support reduces a woman's likelihood
of having pain medications, increases her satisfaction and chances
for 'spontaneous ' birth, and has no known risks. Supportive care
during labour may involve emotional support, information and comfort
measures. Such care may enhance normal labour processes and thus
reduce need for obstetric intervention. The reviewer's offered the
following conclusion: All women should have support throughout labour
and birth.
* Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support
for women during childbirth (Cochrane Review). In: The Cochrane
Library, Issue 3, 2003. Oxford: Update Software.
Ref: www.childbirthconnection.org/pdf.asp?PDFDownload=continuous_support
|
